The commission consisted of 15 members selected by Republican and Democratic leaders. They had six months to hold hearings, debate, discuss and create the report.

The commission's specific charge was to "develop recommendations for the establishment, implementation and financing of a comprehensive, coordinated and high-quality system that ensures the availability of long-term services and supports for individuals who depend on this system to live full and healthy lives."

The report summarizes the challenges looming for policymakers as baby boomers age. Many familiar ideas are discussed, including the importance of at-home caregivers and the need for proper financial arrangements to pay for the care that will be needed.

The report may be helpful in shaping the general issues and advocating for some changes that can improve the long-term outlook on this issue. However, major issues related to financing long-term care costs were remarkably absent.

Five members of the group issued a second report, arguing that their additional comments were necessary because the commission as a whole did not give sufficient attention to the financing issue. The dissenters called for a more expansive, public, long-term services and support (LTSS) system. In addition, the group had other recommendations, such as living wages for home-care workers and expanded Medicaid benefits. The group proposed that the added benefits could be covered by increases in payroll taxes and/or premium supports.

Critics of the alternative report suggested that, while added benefits would be welcome by seniors participating in the Medicaid program, the recommendations may be politically unrealistic. An agreement on a tax increase to pay for a more robust LTSS system is highly unlikely.

The commission's failure to give us hope for help on funding long-term care costs is another reminder of the need for individuals to do everything in their power to make financial arrangements for long-term care. Ideally, the best approach is long-term care insurance built into a comprehensive elder law estate plan. For those who don't have, or cannot obtain, adequate long-term care insurance, a Medicaid asset protection trust protects assets from going to the nursing home.

Bonnie Kraham is an attorney practicing elder law and estate planning with Ettinger Law Firm in the Town of Wallkill. She can be reached at 845-692-8700, ext. 119 or at bkraham@trustlaw.com. This column is intended to provide general information, not legal advice.